You searched for:"Camila Dietrich"
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Original Article
Return to work after discharge from the intensive care unit: a Brazilian multicenter cohort
Rev Bras Ter Intensiva. 2022;34(4):492-498
Abstract
Original ArticleReturn to work after discharge from the intensive care unit: a Brazilian multicenter cohort
Rev Bras Ter Intensiva. 2022;34(4):492-498
DOI 10.5935/0103-507X.20220169-en
Views4See moreABSTRACT
Objective:
To describe the rate and factors related to nonreturn to work in the third month after discharge from the intensive care unit and the impact of unemployment, loss of income and health care expenses for survivors.
Methods:
This was a prospective multicenter cohort study that included survivors of severe acute illness who were hospitalized between 2015 and 2018, previously employed, and who stayed more than 72 hours in the intensive care unit. Outcomes were assessed by telephone interview in the third month after discharge.
Results:
Of the 316 patients included in the study who had previously worked, 193 (61.1%) did not return to work within 3 months after discharge from the intensive care unit. The following factors were associated with nonreturn to work: low educational level (prevalence ratio 1.39; 95%CI 1.10 – 1.74; p = 0.006), previous employment relationship (prevalence ratio 1.32; 95%CI 1 10 – 1.58; p = 0.003), need for mechanical ventilation (prevalence ratio 1.20; 95%CI 1.01 – 1.42; p = 0.04) and physical dependence in the third month after discharge (prevalence ratio 1.27; 95%CI 1.08 – 1.48; p = 0.003). Survivors who were unable to return to work more often had reduced family income (49.7% versus 33.3%; p = 0.008) and increased health expenditures (66.9% versus 48.3%; p = 0.002). compared to those who returned to work in the third month after discharge from the intensive care unit.
Conclusion:
Intensive care unit survivors often do not return to work until the third month after discharge from the intensive care unit. Low educational level, formal job, need for ventilatory support and physical dependence in the third month after discharge were related to nonreturn to work. Failure to return to work was also associated with reduced family income and increased health care costs after discharge.
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Original Article
IMPACTO-MR: a Brazilian nationwide platform study to assess infections and multidrug resistance in intensive care units
Rev Bras Ter Intensiva. 2022;34(4):418-425
Abstract
Original ArticleIMPACTO-MR: a Brazilian nationwide platform study to assess infections and multidrug resistance in intensive care units
Rev Bras Ter Intensiva. 2022;34(4):418-425
DOI 10.5935/0103-507X.20220209-en
Views2ABSTRACT
Objective:
To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria.
Methods:
We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform.
Results:
The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database.
Conclusion:
The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.
Keywords:bacterialBacterial infectionsDatabaseDatabase management systemsDrug-resistanceIMPACTO-MRIntensive care unitsSoftwareSee more -
Original Article
The 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study
Rev Bras Ter Intensiva. 2021;33(3):374-383
Abstract
Original ArticleThe 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study
Rev Bras Ter Intensiva. 2021;33(3):374-383
DOI 10.5935/0103-507X.20210056
Views1See moreABSTRACT
Objective:
To evaluate the ability of the 6-Minute Walk Test to predict long-term physical functional status improvement among intensive care unit survivors.
Methods:
Thirty-two intensive care unit survivors were prospectively evaluated from February 2017 to August 2018 in a post-intensive care unit outpatient clinic in Brazil. Individuals with intensive care unit stays > 72 hours (emergency admissions) or > 120 hours (elective admissions) attending the post-intensive care unit clinic four months after intensive care unit discharge were consecutively enrolled. The association between the 6-Minute Walk Test distance at baseline and physical functional status was assessed over 8 months using the Barthel Index.
Results:
The mean 6-Minute Walk Test distance was significantly lower in intensive care unit survivors than in the general population (405m versus 557m; p < 0.001). Age (β = -4.0; p < 0.001) and muscle weakness (β = -99.7; p = 0.02) were associated with the 6-Minute Walk Test distance. A 6-Minute Walk Test distance was associated with improvement in physical functional status over the 8-month follow-up (odds ratio for each 10m of 1.07; 95%CI 1.01 - 1.16; p = 0.03). The area under the Receiver Operating Characteristic curve for the 6-Minute Walk Test prediction of physical functional status improvement was 0.72 (95%CI 0.53 - 0.88).
Conclusion:
The 6-Minute Walk Test performed 4 months after intensive care unit discharge predicted long-term physical functional status among intensive care unit survivors with moderate accuracy.
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Original Article
Quality of life after intensive care unit: a multicenter cohort study protocol for assessment of long-term outcomes among intensive care survivors in Brazil
Rev Bras Ter Intensiva. 2018;30(4):405-413
Abstract
Original ArticleQuality of life after intensive care unit: a multicenter cohort study protocol for assessment of long-term outcomes among intensive care survivors in Brazil
Rev Bras Ter Intensiva. 2018;30(4):405-413
DOI 10.5935/0103-507X.20180063
Views0ABSTRACT
Objective:
To establish the prevalence of physical, cognitive and psychiatric disabilities, associated factors and their relationship with the qualities of life of intensive care survivors in Brazil.
Methods:
A prospective multicenter cohort study is currently being conducted at 10 adult medical-surgical intensive care units representative of the 5 Brazilian geopolitical regions. Patients aged ≥ 18 years who are discharged from the participating intensive care units and stay 72 hours or more in the intensive care unit for medical or emergency surgery admissions or 120 hours or more for elective surgery admissions are consecutively included. Patients are followed up for a period of one year by means of structured telephone interviews conducted at 3, 6 and 12 months after discharge from the intensive care unit. The outcomes are functional dependence, cognitive dysfunction, anxiety and depression symptoms, posttraumatic stress symptoms, health-related quality of life, rehospitalization and long-term mortality.
Discussion:
The present study has the potential to contribute to current knowledge of the prevalence and factors associated with postintensive care syndrome among adult intensive care survivors in Brazil. In addition, an association might be established between postintensive care syndrome and health-related quality of life.
Keywords:AnxietyCognitive dysfunctionCritical care outcomesDepressionDisabled personsQuality of lifeStress disorders, PosttraumaticSee more -
Original Articles
Functional ability in younger and older elderlies after discharge from the intensive care unit. A prospective cohort
Rev Bras Ter Intensiva. 2017;29(3):293-302
Abstract
Original ArticlesFunctional ability in younger and older elderlies after discharge from the intensive care unit. A prospective cohort
Rev Bras Ter Intensiva. 2017;29(3):293-302
DOI 10.5935/0103-507X.20170055
Views0See moreABSTRACT
Objective:
To compare the functional capacity of younger elderly individuals (60 to 79 years old) with that of older elderly individuals (≥ 80 years old) during the first 6 months after discharge from the intensive care unit.
Methods:
A multicenter prospective cohort study was conducted, in which data on intensive care unit admission and outcomes after hospital discharge (immediate post-discharge, after 3 months and after 6 months) were collected. Muscle strength was evaluated through the protocol of the Medical Research Council and dynamometry (handgrip); the ability to perform activities of daily life and functional independence were assessed by the Barthel index and the usual level of physical activity (International Physical Activity Questionnaire); and quality of life was assessed by the 12-Item Short-Form Health Survey Version 2.
Results:
Among the 253 patients included, 167 were younger elderly (between 61 and 79 years old), and 86 were older elderly (≥ 80 years old). During the sixth month of evaluation, the older elderlies presented a higher need for a caregiver (69.0% versus 49, 5%, p = 0.002). Functional capacity prior to intensive care unit admission and in the third month after discharge was lower in older elderlies than in younger ones (Barthel prior to the intensive care unit: 73.0 ± 30.0 versus 86.5 ± 22.6; p <0.001, Barthel in the third month: 63.5 ± 34.0 versus 71.5 ± 35.5, p = 0.03), as was the usual level of physical activity (International Physical Activity Questionnaire in the third month: active/very active 3.4% versus 18.3%, no physical activity 64.4% versus 39.7%, p < 0.001, and International Physical Activity Questionnaire in the sixth month: active/very active 5.8% versus 20.8%, no physical activity 69.2% versus 43.4%, p = 0.005). Older elderlies had lower muscle strength when assessed according to handgrip in both the dominant (14.5 ± 7.7 versus 19.9 ± 9.6, p = 0.008) and non-dominant limb (13.1 ± 6.7 versus 17.5 ± 9.1, p = 0.02). There were no differences in functional capacity loss or reported quality of life between the age groups.
Conclusion:
Although there were great functional capacity losses after discharge from the intensive care unit in both age groups, there was no difference in the magnitude of functional capacity loss between younger (60 to 79 years) and older elderly individuals (≥ 80 years old) during the first 6 months after discharge from the intensive care unit.
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Original Articles
Functional and psychological features immediately after discharge from an Intensive Care Unit: prospective cohort study
Rev Bras Ter Intensiva. 2013;25(3):218-224
Abstract
Original ArticlesFunctional and psychological features immediately after discharge from an Intensive Care Unit: prospective cohort study
Rev Bras Ter Intensiva. 2013;25(3):218-224
DOI 10.5935/0103-507X.20130038
Views1See moreOBJECTIVE:
To assess the functional and psychological features of patients immediately after discharge from the intensive care unit.
METHODS:
Prospective cohort study. Questionnaires and scales assessing the degree of dependence and functional capacity (modified Barthel and Karnofsky scales) and psychological problems (Hospital Anxiety and Depression Scale), in addition to the Epworth Sleepiness Scale, were administered during interviews conducted over the first week after intensive care unit discharge, to all survivors who had been admitted to this service from August to November 2012 and had remained longer than 72 hours.
RESULTS:
The degree of dependence as measured by the modified Barthel scale increased after intensive care unit discharge compared with the data before admission (57±30 versus 47±36; p<0.001) in all 79 participants. This impairment was homogeneous among all the categories in the modified Barthel scale (p<0.001) in the 64 participants who were independent or partially dependent (Karnofsky score ≥40) before admission. The impairment affected the categories of personal hygiene (p=0.01) and stair climbing (p=0.04) only in the 15 participants who were highly dependent (Karnofsky score <40) before admission. Assessment of the psychological changes identified mood disorders (anxiety and/or depression) in 31% of the sample, whereas sleep disorders occurred in 43.3%.
CONCLUSIONS:
Patients who remained in an intensive care unit for 72 hours or longer exhibited a reduced functional capacity and an increased degree of dependence during the first week after intensive care unit discharge. In addition, the incidence of depressive symptoms, anxiety, and sleep disorders was high among that population.
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Case reports Child Coronavirus infections COVID-19 Critical care Critical illness Extracorporeal membrane oxygenation Infant, newborn Intensive care Intensive care units Intensive care units, pediatric mechanical ventilation Mortality Physical therapy modalities Prognosis Respiration, artificial Respiratory insufficiency risk factors SARS-CoV-2 Sepsis